Immunology and basic Microbiology Flashcards
(124 cards)
1
Q
Immune system
organs (2nd)
A
2° organs: Allow immune cells to interact with antigen
P - Peyer patches L - lymph nodes a T - tonsils S - Spleen
2
Q
Lymph node Medulla Consists of
A
- medullary cords (closely packed lymphocytes and plasma cells) and medullary sinuses.
- Medullary sinuses communicate with efferent lymphatics and contain reticular cells and macrophages.
3
Q
Internal iliac nodes drain the…
A
Lower rectum to anal canal (above pectinate line), vagina (middle third), prostate.
(bladder, cervix- both)
4
Q
External iliac drain the…
A
body of uterus
cervix, bladder in both Internal iliac and External iliac
5
Q
Both Internal iliac and External iliac. drain the…
A
cervix, bladder in both Internal iliac and External iliac
6
Q
Cervical supraclavicular drain the…
A
Head and neck (URI, Mono, Kawasaki - KUM)
7
Q
Mediastinal drain the…
A
Trachea and esophagus
Primary lung cancer
Granulomatous disease
8
Q
Hilar drain the…
A
Lungs
Granulomatous disease
9
Q
Para-aortic drain the…
A
Testes. ovaries. kidneys. uterus -> Metastasis
10
Q
Popliteal nodes drain the:
A
Dorsolateral foot posterior calf -> Lateral foot/ leg cellulitis
11
Q
Superficial inguinal nodes drain the_____
A
Anal canal (below pectinate fine skin below), umbilicus (except popliteal area). scrotum. vulva
12
Q
Hassal corpuscules are part of…
and contain
A
Hassal corpuscules are located in the thymus medulla along with mature t-cells and reticular cells.
13
Q
Thymoma- neoplasm of the thymus.
associated with
A
myasthenia gravis, superior vena cava
syndrome, pure red cell aplasia, Good
syndrome.
MS Pure & Good
14
Q
PAMPS are..
A
LPS
N.A. (Virus)
Flagellin
15
Q
Spleen white pulp has
A
Follicules (B cells)
PALS (T cells)
16
Q
Spleen red pulp has
A
Sinusoids - long, vascular channels in reed pulp with fenestrated “barrel hoop” basement membrane.
17
Q
Spleen marginal zone has
A
BAM! presentation!
B cells
APC
Macrophages
18
Q
Postsplenectomy blood findings:
A
- Howell-Jolly bodies (nuclear remnants)
- Target cells
- Thrombocytosis (loss of sequestration and removal)
- Lymphocytosis (loss of sequestration)
19
Q
HLA SUBTYPE A3
DISEASE
A
Hemochromatosis
20
Q
HLA SUBTYPE B8
DISEASE
A
Addison disease, myasthenia gravis, Graves
disease
Bate (B8) Addison to Graves(2)
21
Q
HLA SUBTYPE B27
DISEASE
A
Psoriatic arthritis, Ankylosing spondylitis,
IBD-associated arthritis, Reactive arthritis
PAIR
22
Q
HLA SUBTYPE C
DISEASE
A
Psoriasis
P”C”riasis
23
Q
HLA SUBTYPE DQ2/DQ8
DISEASE
A
Celiac disease
24
Q
HLA SUBTYPE DR2/3
DISEASE
A
SLE
25
HLA SUBTYPE DR2
| DISEASE
Multiple sclerosis, hay fever, SLE,
Goodpasture syndrome
Multiple hay pastures are dirty (DR2).
26
HLA SUBTYPE DR3/5
| DISEASE
Hashimoto
27
HLA SUBTYPE DR3
| DISEASE
DM type I, SLE, Graves disease, Addison disease
Addison in front of 1 grave
28
HLA SUBTYPE DR4
| DISEASE
Rheumatoid arthritis, DM type 1, Addison
disease
Addison in 1 room
29
Natural killer cells Activity enhanced
by IL-2, IL-12, IFN-alfa , and IFN-beta.
30
T -cell subset Th1
| secrets
IL 2
| IFN gamma
31
T -cell subset Th2
| secrets
IL 4,5,6,10,13
32
T -cell subset Th17
| secrets
IL 17, 21, 22
33
T -cell subset Treg
| secrets
TGF beta
| IL 10, 35
34
T -cell subset Th1
| induced by
IL 12
| IFN gamma
35
T -cell subset Th2
| induced by
IL 2,4
36
T -cell subset Treg
| induced by
TGF beta
| IL2
37
T -cell subset Th17
| induced by
TGF-beta
| IL 6, 1
38
T -cell subset Th1
| inhibited by
IL 4
| IL 10
39
T -cell subset Th2
| inhibited by
IFN gamma
40
T -cell subset Th17
| inhibited by
IL 4
| IFN gamma
41
T -cell subset Treg
| inhibited by
IL-6
42
Important cytokines
| SECRETED BY MACROPHAGES
Acute (IL- I, IL-6, TNF-a), then recruit (IL-8, IL-12).
43
interleukin-1
F - fever
A - acute inflammation.
C - chemokine secretion - recruit WBCs.
E - endothelium activation - express adhesion molecules.
Also known as an osteoclast-activating factor.
44
interleukin-6
Causes fever and stimulates the production of acute-phase
| proteins.
45
Tumor necrosis
| factor-a
W - WBC recruitment
E - endothelium( Activation)
L - leak (vascular)
46
lnterleukin-8
Major chemotactic factor for neutrophils.
47
lnterleukin-12
Induces differentiation ofT cells into Th I cells.
| Activates NK cells.
48
Important cytokines
| SECRETED BY ALL T CELLS
lnterleukin-2
| lnterleukin-3
49
lnterleukin-2
Stimulates growth of helper, cytotoxic, and
| regulatory T cells, and NK cells.
50
nterleukin-3
Supports growth and differentiation of bone
| marrow stem cells. Functions like CM-CSF.
51
Cell surface proteins
| T cells
TCR (binds antigen-Ml IC complex)
CD3 (associated with TCR for signal transduction)
CD28 (binds B7 on APC)
52
Cell surface proteins
| Helper T cells
CD4, CD40L, CXCR4/CCR5 (co-receptors for HIV)
53
Cell surface proteins
| Cytotoxic T cells
CD8
54
Cell surface proteins
| Regulatory T cells
CD4,CD25
55
Cell surface proteins B cells
lg (binds antigen)
CDl9, CD20, CD21 (receptor for Epstein-Barr virus), CD40
MHC II, B7
56
Cell surface proteins
| Macrophages
CDl4 (receptor for PAMPs, eg, LPS), CD40
CCR5
MHC II, B7 (CD80/86)
Fc and C3b receptors (enhanced phagocytosis)
57
Cell surface proteins
| NK cells
CDl6 (binds Fe of lgG), CD56 (suggestive
| marker for NK)
58
Cell surface proteins
| Hematopoietic stem cells
CD 34
59
Passive immunity for
After exposure to Tetanus toxin, Botulinum
toxin, IIBV, Varicella, Rabies virus, or
Diphtheria toxin, unvaccinated patients are
given preformed antibodies (passive)- "To Be
Healed Very Rapidly Before Dying"
60
live attenuated
| vaccine
```
Adenovirus (nonattenuated,
given to military recruits},
Typhoid (Ty21a, oral},
Polio (Sabin}, Varicella
(chickenpox}, Smallpox,
BCC, Yellow fever, Influenza
(intranasal}, MMR, Rotavirus
"Attention Teachers! Please
Vaccinate Small, Beautiful
Young Infants with MMR
Regularly!"
```
61
Killed or inactivated
| vaccine
```
Rabies, influenza (injection),
Polio (Salk}, hepatitis A,
typhoid (Vi polysaccharide,
intramuscular)
Sa lK = Killed
RIP At Times
```
62
Subunit vaccine
```
HBV (antigen = HBsAg),
HPV (types 6, 11, 16, and
18), acellular pertussis
(aP}, Neisseria meningitidis
(various stra ins), Streptococcus
pneumoniae, Haemophilus
influenza type b.
Be PP SHIN
```
63
Arthus reaction
a local subacute immune
complex-mediated hypersensitivity reaction.
intradermal injection of antigen into a
pre-sensitized (has circulating IgG) individual
leads to the immune complex formation in the
skin. Characterized by edema, necrosis, and
activation of complement.
64
Type I
| hypersensitivity Phases
Anaphylactic and atopic-two phases:
• Immediate (minutes)
• Late (hours)
65
Type I
hypersensitivity
Immediate (minutes):
antigen crosslinks
preformed lgE on presensitized mast cells
- immediate degranulation - release of
histamine (a vasoactive amine} and tryptase
(a marker of mast cell activation}.
66
Type I
hypersensitivity
ILate (hours}:
chemokines (attract inflammatory cells, eg, eosinophils) and
other mediators (eg, leukotrienes} from mast
cells - inflammation and tissue damage.
67
Common variable
immunodeficiency
PRESENTATION
Usually presents after age 2 and may be considerably delayed;
dec. Plasma cells, dec. Igs
```
LABS
L - Lymphoma,
A - Autoimmune disease
B - Bronchiectasis
S - Sinopulmonary infections
```
68
Autosomal dominant
hyper-lgE syndrome
(Job syndrome)
PRESENTATION
```
FATED
Facies/Fractures
Abscesses (cold)
Teeth (baby)
Eosinophils/IgE
Dermatologic eczema/dominant.
```
69
Ataxia-telangiectasia
| PRESENTATION
```
Lymphoma and leukemia.
AFP inc.
Lymphopenia, cerebellar atrophy.
IgA dec
LALA
```
70
Hyper-lgM syndrome
X-linked recessive.
Failure to make gerMinal
centers.
71
Wiskott-Aldrich
| syndrome findings
gAmE (Ig- caps inc, lower case dec.)
WATER: Wiskott-Aldrich:
thrombocytopenia, Eczema, Recurrent (pyogenic) infections.
72
Chediak-Higashi
| syndrome
PLAIN: Progressive neurodegeneration,Lymphohistiocytosis, Albinism (partial), recurrent pyogenic Infections, peripheral Neuropathy.
73
Infections in immunodeficiency
| - Bacteria (no T-cells)
Sepsis
74
Infections in immunodeficiency
| - Viruses (no T-cells)
CMV, EBV, JC
virus, VZV, chronic
infection with
respiratory/GI viruses
75
Infections in immunodeficiency
| - Fungi/parasites (no T cells)
Candida (local), PCP, Cryptococcus
76
Infections in immunodeficiency - Bacteria (no B-cells)
```
Encapsulated (Please
SHINE my SKiS):
Pseudomonas
aeruginosa,
Streptococcus
pneumonia,
Haemophilus
Influenzae type b,
Neisseria
meningitis,
Escherichia coli,
Salmonella,
Klebsiella
pneumoniae,
Group B
Streptococcus
```
77
Infections in immunodeficiency - Viruses (no B-cells)
```
Enteroviral
encephalitis,
poliovirus
(live vaccine
contraindicated)
```
78
Infections in immunodeficiency - Fungi/parasites (no B-cells)
GIgiardiasis (no IgA)
79
Infections in immunodeficiency - Bacteria (no GRANULOCYTES)
```
Staff Break Pseudo! Not serious:
Staphylococcus,
Burkholderia cepacia,
Pseudomonas
aeruginosa, Nocardia,
Serratia
```
80
Infections in immunodeficiency - Fungi/parasites (no GRANULOCYTES)
Candida (systemic),
Cryptococcus
Aspergillus
Mucor
81
infections in immunodeficiency - Bacteria (no complement)
```
Encapsulated
species with early
complement
deficiencies
Neisseria with late
complement (C5-
C9) deficiencies
```
82
Alemtuzumab
TARGET
CLINICAL USE
CD52
| CLL, MS
83
Bevacizumab
TARGET
CLINICAL USE
VEGF
Colorectal cancer, renal cell
carcinoma, non-small cell
lung cancer
```
Also used for neovascular age-related
macular degeneration,
proliferative diabetic
retinopathy, and macular
edema
```
CoLoREtaL
84
Rituximab
TARGET
CLINICAL USE
```
CD20
CRIB =B-cell non-Hodgkin
lymphoma, CLL, rheumatoid
arthritis, ITP, MS
Risk of PML in patients with
JC virus
```
85
Trastuzumab
TARGET
CLINICAL USE
HER2
| Breast cancer, gastric cancer
86
Adalimumab,
infliximab
TARGET
CLINICAL USE
Soluble TNF-a
PAIR=IBO, rheumatoid arthritis,
ankylosing spondylitis,
psoriasis
87
Etanercept is a
decoy TNF-a receptor and not a
| monoclonal antibody
88
Eculizumab
TARGET
CLINICAL USE
Complement protein C5
Paroxysmal nocturnal
hemoglobinuria
89
Natalizumab
TARGET
CLINICAL USE
```
a4-integrin
MS, Crohn disease
a4-integrin: WBC adhesion
Risk of PML in patients with
JC virus
```
90
Denosumab
TARGET
CLINICAL USE
RANKL
Osteoporosis; inhibits osteoclast maturation
(mimics osteoprotegerin)
91
Omalizumab
TARGET
CLINICAL USE
IgE
Refractory allergic asthma;
prevents IgE binding to FceRI
92
Palivizumab
TARGET
CLINICAL USE
RSV F protein
| RSV prophylaxis for high-risk infants
93
Ustekinumab
TARGET
CLINICAL USE
IL-12/IL-23
| Psoriasis, psoriatic arthritis
94
Periplasm location and significance
Space between the cytoplasmic membrane
and outer membrane in gram neg bacteria.
(Peptidoglycan in middle.)
Accumulates components exiting gram
neg cells, including hydrolytic enzymes
(eg, beta-lactamases).
95
Pleomorphic bacteria
Have no rigid cell walls.
Examples include Anaplasma, Ehrlichia, Chlamydiae, Rickettsiae, Mycoplasma, Ureaplasma.
U-CREAM
96
These bugs do not Cram stain well...
Treponema, Leptospira,Mycobacteria, Mycoplasma, Ureaplasma, Legionella, Rickettsia, Chlamydia, Bartonella, Anaplasma, Ehrlichia
TeLL MUM B CLEAR
97
Giemsa stain bugs
Rickettsia, Chlamydia, Trypanosomes,
Plasmodium, Borrelia, Helicobacter pylori
Ricky got Chlamydia as he Tried to Please the
Bored Ilot "Geisha."
98
Periodic a cid- Schiff
| stain
Stains glycogen, mucopolysaccharides; used
to diagnose Whipple disease (Tropheryma
Whipple
99
Ziehl-Neelsen stain
| carbol fuchsin
Acid-fast bacteria (eg, Mycobacteria,
Nocardia; stains mycolic acid in the cell wall);
protozoa (eg, Cryptosporidium oocysts)
```
Auramine-rhodamine stain is more often used
for screening (inexpensive, more sensitive).
```
100
India ink stain
Cryptococcus neoformans; mucicarmine
can also be used to stain thick polysaccharide
capsule red
101
Silver stain
Fungi (eg, Coccidioides, Pneumocystis
Jiirovecii), Legionella, helicobacter pylori
F His Life
102
Fluorescent antibody stain
Used to identify many bacteria, viruses,
Pneumocystis Jirovecii, Giardia, and
Cryptosporidium.
103
Thayer-Martin agar has
Selective ly favors growth of Neisseria by
inhibiting the growth of gram (+) organisms
with Vancomycin, gram (-) organisms except
Neisseria with Trimethoprim and Colistin,
and fungi with Nystatin
Vice City News Team
104
Aerobes
Nocardia, Pseudomonas
aeruginosa, Mycobacterium tuberculosis, and
Bordetella pertussis.
105
Anaerobes
Clostridium, Bacteroides,
Fusobacterium, and Actinomyces israelii
AminO2glycosides are
ineffective against anaerobes because these
antibiotics require O2 to enter into bacterial
cell.
106
Facultative anaerobes
Streptococci, staphylococci, and enteric gram (-)
| bacteria.
107
Obligate intracellular bacteria
Rickettsia, Chlamydia, Coxiella. Rely on host
ATP.
Stay inside (cells) when it is Really Chi lly and
Cold.
108
Facultative
intracellular
bacteria
Salmonella, Neisseria, Bruce/la, Mycobacterium,
Listeria, Francisella, Legionella, Yersinia pestis
Bruces List SNM FacultativeLY.
109
Urease-positive organisms
Proteus, Cryptococcus, H pylori, Ureaplasma, Nocardia, Klebsiella, S epidermidis, S saprophyticus. Urease hydrolyzes urea to release ammonia and C02 - inc. pH
Predisposes to struvite (ammonium magnesium phosphate) stones, particularly Proteus.
Pro CHUNKSS.
110
Catalase-positive
| organisms
Nocardia, Pseudomonas, Listeria,
Aspergillus, Candida, E coli, Staphylococci,
Serratia, B cepacia, H pylori.
PS BLANCHES
111
Type Ill secretion
| system
Needle-like protein appendage fac ilitating d irect delivery of toxins
(eg, Pseudomonas, Salmonella, Shigella, E coli)
PuShES
112
Sporicidal Disinfection & sterilization
```
Chlorine
Autoclave
Ethylene oxide
Hydrogen peroxide
Iodine and iodophors (maybe)
EACH I
```
113
Non-Sporicidal Disinfection & sterilization
Quaternary amines
Chlorhexidine
Alcohols
Quarters Are Cool
114
Early complement
| deficiencies (C1-C4)
Increased risk of severe, recurrent pyogenic sinus and respiratory tract infections.
Increased risk of
SLE.
115
Oxidative burst also leads to...
K+ influx, which releases lysosomal enzymes.
116
Pyocyanin of P aeruginosa generates...
ROS to kill competing pathogens.
117
Lactoferrin is a protein found in_____(2) that inhibit microbial growth via______
secretory fluids and
neutrophils
iron chelation.
118
Combined passive and active immunizations
| can be given for... (2)
hepatitis B or rabies exposure
119
AUTOANTIBODIES for Polymyositis, dermatomyositis
Antisynthetase (eg, anti-Jo-I)
anti-SRP
antihelicase (anti-Mi-2)
120
AUTOANTIBODIES for SLE
```
Anticardiolipin
lupus anticoagulant
Antinuclear (ANA)
Anti-dsDNA
anti-Smith
```
121
AUTOANTIBODIES for Antiphospholipid syndrome
Anticardiolipin
lupus anticoagulant
Anti-beta 2 glycoprotein I
122
Endotoxin
```
ENDOTOXINS:
Edema
Nitric oxide
DIC/Death
Outer membrane
TNF-a
O -antigen + core polysaccharide + lipid A
eXtreme ly heat stable
IL-I and IL-6
Neutrophil chemotaxis
Shock
```
Three main effects: macrophage activation
(TLR4/CDl4), complement activation, and
tissue factor activation.
123
Pseudomonas aeruginosa Produces
Produces PEEP:
```
Phospholipase C (degrades cell membranes);
Endotoxin (fever, shock);
Exotoxin A (inactivates EF-2);
Pigments: pyoverdine and pyocyanin (blue-green pigment)
```
124
False-Positive results on VDRL with:
Pregnancy
Viral infection (eg, EBV, hepatitis}
Drugs
Rheumatic fever
Lupus and leprosy
